Download Eligible Health Savings Account Expense

 Eligible Expense Examples ‐ There are hundreds of eligible expenses for tax‐free purchase with your account funds, including prescriptions, doctor’s office copays, health insurance deductibles, and coinsurance. Many over‐
the‐counter (OTC) treatments are also eligible, though keep in mind that many require a prescription, letter of medical necessity, or doctor’s directive.*  Acupuncture  Physical exam  Hearing aids  Alcoholism treatment  Physical therapy  Hospital services  Ambulance  Prescription drugs  Immunization  Artificial limb  Psychiatric care  Insulin and diabetic supplies  Birth control pills  Retiree (post‐65)  Laboratory fees medical insurance  Blood pressure monitoring  Laser eye surgery premiums (post‐tax) device  Long‐term care premiums or  Smoking cessation  Breast pumps and related expenses (post tax)** program and supplies  Medical testing devices medications*  Chiropractic care  Nursing services  Surgery  COBRA premiums (post tax  Obstetrical expenses  Sunscreen & sun block only)  Orthodontia (not for cosmetic (SPF 15+, broad  Contact lenses and related reasons) spectrum) materials  Over‐the‐counter (OTC)  Transportation for  Dental treatment treatments containing medical care medicine– cold treatments,  Dentures 
Weight loss program ointments, pain relievers,  Diagnostic services to necessary to treat a stomach remedies, etc*  Drug addiction treatment specific medical  Over‐the‐counter (OTC)  Eye examination, eye glasses condition treatments without medicine and reading glasses  Wheelchair, walkers, – bandages, wraps, medical  Family planning items crutches and canes
testing devices, etc  Fertility treatment 
Oxygen  Flu shot Ineligible Expense Examples ‐ These items are not generally eligible for tax‐free purchase with your account funds. 

Concierge service fees (billed for future services; no treatment provided) Cosmetics and cosmetic surgery 






Deodorant Exercise equipment Fitness programs Funeral expenses Hair transplants Household help 

Illegal operations and treatments Maternity clothes Teeth whitening
Dual Purpose Items – Items that can be used for a medical purpose or for general health and well‐being are considered “dual purpose” and are eligible only with a prescription, doctor’s directive or letter of medical necessity. Examples include: 


Dietary and weight loss supplements Fiber supplements Orthopedic shoes and inserts 

Snoring cessation aids Vitamins and herbal supplements *OTC items that contain a drug or medication require a prescription in order to be reimbursed. A “prescription” means a written or electronic order for a medicine or drug that meets the legal requirements of a prescription in the state where the medical expense is incurred, and the prescription must be issued by an individual who is legally authorized to issue a prescription in that state. **Limitations apply. See IRS Publication 502 for more information. © 2017 ConnectYourCare, LLC. All Rights Reserved.